title: Efficacy and safety of catheter ablation for long-standing persistent atrial fibrillation in women.
abstract: OBJECTIVE
  It is uncertain whether gender affects the outcomes of catheter ablation (CA) for atrial fibrillation (AF). The objective of the study is to evaluate the efficacy and safety of CA for long-standing persistent AF in women.
  
  
  METHODS
  Between January 2010 and May 2011, 220 consecutive patients (73 females, 33.2%), with long-standing persistent AF who underwent CA were prospectively recruited. Gender-related differences in clinical presentation, periprocedural complications, and outcomes were compared.
  
  
  RESULTS
  Women were less likely to have lone AF than men (27.4% vs 47.6%; P = 0.004). The incidence of rheumatic heart disease was higher in women (19.2% in women vs 1.4% in men; P < 0.001). Women had a lower initial ablation success rate than men (35.6% vs 57.1%; P = 0.003). Hematomas occurred more often in women (6.8% in women vs 0.7% in men; P = 0.027). A Cox regression analysis demonstrated total duration of AF (per month, hazard ratio [HR] 1.003, confidence interval [CI] 1.001-1.006; P = 0.006) and gender (HR 1.663, CI 1.114-2.485; P = 0.013) as the independent predictors for recurrence after the first CA.
  
  
  CONCLUSIONS
  Women and long AF duration were closely related to the recurrence of AF after the first ablation in patients with long-standing persistent AF. Women also had a higher risk of vascular complications.
authors.affiliation: Department of Cardiology, Shanghai Chest Hospital affiliated to Shanghai Jiaotong University, Shanghai, China.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Zhang
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Tan
authors.forename: Jun
authors.initials: J
authors.lastname: Gu
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Jiang
authors.forename: Liang
authors.initials: L
authors.lastname: Zhao
authors.forename: Yuan-Long
authors.initials: YL
authors.lastname: Wang
authors.forename: Yu-Gang
authors.initials: YG
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.forename: Jia-Ning
authors.initials: JN
authors.lastname: Gu
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
mesh_terms: D001281:Atrial Fibrillation / Q000401:mortality* / Q000601:surgery*; D017115:Catheter Ablation / Q000401:mortality*; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome; D016387:Women's Health / Q000706:statistics & numerical data*
keywords: Atrial fibrillation; Catheter ablation; Recurrence; Women